Tuesday, April 10, 2007

Grand Rounds Vol 3, No.29

G'day and welcome to this weeks edition of Grand Rounds. Dr Dork is pleased and honoured to host your journey through some highlights of this weeks medical blogging.

No time to shave today

Dr Dork has elected to follow the early tradition of Grand Rounds, as established and maintained by Nick Genes, venerable beyond his years in this regard. To elucidate, a few posts that have stood out, in this editor's opinion, have been selected for each category, to keep this edition of Grand Rounds to a readable size.

There were roughly quadruple the number of submissions for the (arbitrarily) designated size of this edition. Many quality submissions were regrettably left out this week, apologies to all. Dr Dork wouldn't have made the cut himself amongst the field of entries this week.

For those with particular preferences and predilections, the 30 selections for this week have been compiled into the following categories:

Rants

In Practice

Of Patients and for Patients

Education

Research and Advances

Healthcare Policy and Reform

Medicine in the Media

Miscellany and Mirth

Lastly, In Parting, we have a bittersweet farewell from the greatly admired Barbados Butterfly.

Rants

Fallen Angels rants on discourtesy in the healthcare blogosphere in Doctor Bloggers

Dr Kenneth F. Trofatter discusses the evaluation of Recurrent Early Pregnancy Loss as part of an ongoing series on the topic. An increasing problem, one presumes, as many elect to become parents later and later, it seems.

Fat Doctor shares a moral dilemma as an overzealous schoolteacher almost berates her into support of developing SuperBugs.

Azygos shares a poignant tale of a patient's death from Multiple Sclerosis, and touches on the dangers of a fragmented care system in Paul

Signout, in the midst of a trying cardiology rotation, is touched by the power of a simple gesture of thanks in What we're supposed to do.

Dr Shazam of Mr Hassle's Long Underpants (still one of the best blog names, period) shares the electricity, and the enervation, of emergency room codes in Fallen Star.

Adam of Daylight Atheism gives a disturbing account of the situation faced by those in the Congo, where a single, lone psychiatrist, Dr Alain Mouanga, struggles to turn the tide of abuse inflicted upon the mentally ill.

Dancing Bare gives us a taste of Gilbert and Sullivan with an ode to Dr. Mom.

Roy of Shrink Rap gives an emotive, heartwarming view of the necessity of humour in preserving sanity in the face of tragedy in laughter is a drug. Dr Dork couldn't agree more. Ijeoma Eleazu reminds us that April is national humour month for American readers.

Dr Karen Little, a South African intern, of Just Up the Dose, shares with us some stomach churning experiences in a post succinctly titled ew.

Nurse Ratched shares with us some outstanding additions to her vast collection of medical pulp fiction. Ah, those were the days....

What ? Time for my sponge bath already ?

In Parting

Charity Docshares an ode dedicated to the much admired Barbados Butterfly whose wings have been sadly clipped.

It is common knowledge, after some dubious leakage to a major Australian newspaper, that Dr Barb was (in this Dork's, and many others opinions) inappropriately reprimanded by her hospital administration. Dr Dork recalls his many 100+ hour weeks from his hospital training days. Even back then many administrators preferred to deny the ridiculously unsafe hours many doctors worked. Unsafe for patients and doctors both. Dr Dork suspects this is what got Dr Barb in trouble...but we will, sadly, possibly never know.

Dr Dork has badgered Dr Barb into providing an "approved statement", which follows.

Thanks to everyone for your well wishes, kind words, expressions of concernand thoughtful tributes in recent weeks – I was amazed to realise the extentto which the Barbados Butterfly blog had touched and inspired others sinceits beginning in 2005. As the blogosphere has reported, the BB blog has been down since March 15th 2007.

The 2006 post “Tips For Surgical Intern #1” stated that in a bad situationyou can either leave it, reframe it, accept it or change it. In somesituations change is the only option. It may be daunting and difficult, butthat must not dissuade us from trying. Surgical training is necessarilyhard, but there are some paths that trainees should not have to walk. Longterm readers will recall my Darker Days series:

“I do know that as a profession we need to do better. We need to promote aculture of safety. We need humane leaders - both clinicians andadministrators. We need to value our colleagues and create work environmentsthat we feel confident about and excited to be a part of.”

I am grateful that there are people who are both willing to accept the needfor change and willing to act. My blog is down and I shall miss sharing mystories with you, but I sleep restfully (my pager notwithstanding!) andcontinue to wield my scalpel with a smile. We live in exciting times.

“If nothing ever changed, there would be no butterflies.” – Anonymous.

Best wishes and much love to all,Barbados Butterfly

That's all for this week. Next weeks edition of Grand Rounds will be hosted by The Fat Doctor.

Excellent, as anticipated. Many thanks for including me in the fun, and especially thanks for letting us know that BB is ok. (Any linkage available to the "major Australian newspaper" leakage mentioned?)

Love Grand Rounds today, Dr Dork - excellent work! Those pics are just in time...it's a big pain day over here at ChronicBabe HQ, and I was in desperate need of a laugh. Many thanks for your good work -

Thanks, Dr. Dork, for a terrific edition of Grand Rounds. Thanks, too for including my ranting and raving (no response yet by the reporter). I especially appreciate the gravitas you bring to GR, as well as conveying the farewell from BB (I really miss reading her blog - maybe she will consider blogging about something else - she's a wonderful writer).

Thank you so much, Dr., for including my post. It was the hardest post I've ever written and I agonized over whether to punch the "publish" button many times. Thanks for hosting the GR and it was a great job! I'm sitting down to have a bunch of good reads with a cup of....some good coffee!

Fine job Dr. D. I too was happy to see that "Barb" continues to do well, although I imagine that anyone brave enough to use a scalpel on a living, breathing person is brave enough to handle most anything. :)

Dr. D,Thanks for including me in this week's GR. I laughed and I cried. Especially liked Dr. Little's dissertation. We will have to get together to share some OB/GYN horror stories together! Keep up the great work!

hey doc, g'day from the northern hemisphere. thanks for linking my site on your excellent blog. i have now linked you and will visit regularly. have a fellow physician just returned from iraq who staffed one of the MASH units with some aussies and he was very impressed with their skills and training. as we say in my part of the world, "y'all come back anytime".cheers

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Dr Dork is a real doctor.
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Dr Dork is at times bemused, at times amused, at times angered, by what he sees in modern medicine.
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